泡型包虫病脑转移的MRI特征

MRI features of brain metastasis of alveolar echinococcosis

目的 探讨泡型包虫病脑转移的MRI特征,提高对该病的认识。方法 20例脑转移性泡型包虫病均行MRI、CT、B超和实验室检查,经临床手术病理证实,资料完整。结果 20例脑转移性泡型包虫病,均有原发肝泡型包虫病史,其中12例曾行手术治疗,8例行B超引导下肝穿刺治疗或活检;20例中,单发病灶4例(20%),多发病灶16例(80%);合并肺转移6例,肾和肾上腺转移3例。MRI表现为类圆形或不规则形多发聚集的小囊泡样改变,断面呈"蜂窝状",T1WI和T2WI均以低信号为主。病灶周围伴有明显水肿。4例于肝静脉和门静脉内显示"泡球蚴"栓子。结论 颅脑是泡型包虫病最好发生转移的部位之一。MRI"蜂窝状"小囊泡样改变,T1WI和T2WI均为低信号是其特征性表现。

Objective：To investigate the MRI manifestations of brain metastasis of alveolar echinococcosis so as to gain more insights into the disease. Materials and Methods：Twenty cases of alveolar echinococcosis underwent MRI,CT,ultrasound and laboratory-related examinations and were confirmed by surgical pathology,all the data were analyzed. Results：All of 20 patients with brain metastatic alveolar echinococcosis had primary history of hepatic alveolar echinococcosis. Twelve of them had received surgical treatment,while 8 of them had undergone ultrasound-guided puncture treatment or biopsy. Four of 20 cases had single lesion （20%）,16 cases had multiple lesions （80%）. There were pulmonary metastasis in 6 cases,kidney and adrenal gland metastasis in 3 cases. MRI features were as follows：There were round or irregular-shaped multiple aggregation of small vesicles-like changes,the cross section was honeycomb shape,T1WI and T2WI showed mainly low signals. The lesions were accompanied by obvious edema. ＇Alveolar echinococcosis＇ embolus in hepatic vein and portal vein were found in 4 cases. Conclusion：Brain is one of the most vulnerable organs of hepatic alveolar echinococcosis. MRI manifestations such as honeycomb-shaped small vesicles and T1WI,T2WI low signals is the valuable characteristics of brain metastasis of alveolar echinococcosis.